AHRQ QI, Inpatient Quality Indicators #28, Technical Specifications, Hysterectomy Rate www.qualityindicators.ahrq.gov

Hysterectomy Rate

Inpatient Quality Indicators #28 Technical Specifications Area-Level Indicator Procedure Utilization Indicator AHRQ Quality Indicators, Version 4.4, March 2012

Numerator

Female discharges age 18 years and older with a hysterectomy procedure. ICD-9-CM Hysterectomy procedure codes1: 683 SUBTOT ABD HYSTERECTOMY 6859 VAG HYSTERECTOMY NEC/NOS 6831 LAP SCERVIC HYSTERECTOMY 686 RADICAL ABD HYSTERECTOMY 6839 SUBTOTL ABD HYST NEC/NOS 6861 LAP RADICAL ABDOMNL HYST 684 TOTAL ABD HYSTERECTOMY 6869 RADICAL ABD HYST NEC/NOS 6841 LAP TOTAL ABDOMINAL HYST 6871 LAP RADICAL VAGINAL HYST 6849 TOTAL ABD HYST NEC/NOS 6879 RADICAL VAG HYST NEC/NOS 685 VAGINAL HYSTERECTOMY 687 RADICAL VAG HYSTERECTOMY 6851 LAP AST VAG HYSTERECTOMY 689 HYSTERECTOMY NEC/NOS 1 Italicized codes are not active in the current fiscal year. ------

Exclude cases: • with genital cancer in any diagnosis field • with pelvic or lower abdominal trauma in any diagnosis field • MDC 14 (pregnancy, childbirth, and puerperium) • with missing discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing) or principal diagnosis (DX1=missing)

ICD-9-CM Female genital cancer diagnosis codes1: 179 MALIG NEOPL NOS 1841 MAL NEO MAJORA 1800 MALIG NEO ENDOCERVIX 1842 MAL NEO 1801 MALIG NEO EXOCERVIX 1843 MALIGN NEOPL 1808 MALIG NEO NEC 1844 MALIGN NEOPL NOS 1809 MAL NEO CERVIX UTERI NOS 1848 MAL NEO FEMALE GENIT NEC 181 MALIGNANT NEOPL PLACENTA 1849 MAL NEO FEMALE GENIT NOS 1820 MALIG NEO CORPUS UTERI 2331 CA IN SITU CERVIX UTERI 1821 MAL NEO UTERINE ISTHMUS 2332 CA IN SITU UTERUS NEC 1828 MAL NEO BODY UTERUS NEC 2333 CA IN SITU FEM GEN NEC 1830 MALIGN NEOPL 23330 CA IN SITU FEM GEN NOS 1832 MAL NEO 23331 CARCINOMA IN SITU 1833 MAL NEO BROAD 23332 CARCINOMA IN SITU VULVA 1834 MALIG NEO 23339 CA IN SITU FEM GEN NEC 1835 MAL NEO ROUND LIGAMENT 2360 UNCERT BEHAV NEO UTERUS 1838 MAL NEO ADNEXA NEC 2361 UNC BEHAV NEO PLACENTA 1839 MAL NEO ADNEXA NOS 2362 UNC BEHAV NEO OVARY 1840 MALIGN NEOPL VAGINA 2363 UNC BEHAV NEO FEMALE NEC 1 Italicized codes are not active in the current fiscal year.

Page 1 AHRQ QI, Inpatient Quality Indicators #28, Technical Specifications, Hysterectomy Rate www.qualityindicators.ahrq.gov

ICD-9-CM Pelvic or lower abdominal trauma diagnosis codes: 8674 UTERUS INJURY-CLOSED 86819 INTRA-ABDOM INJ NEC-OPEN 8675 UTERUS INJURY-OPEN 8690 INTERNAL INJ NOS-CLOSED 8676 PELVIC ORGAN INJ NEC-CL 8691 INTERNAL INJURY NOS-OPEN 8677 PELVIC ORGAN INJ NEC-OPN 8796 OPEN WOUND OF TRUNK NEC 8678 PELVIC ORGAN INJ NOS-CL 8797 OPEN WND TRUNK NEC-COMPL 8679 PELVIC ORGAN INJ NOS-OPN 8798 OPEN WOUND SITE NOS 86800 INTRA-ABDOM INJ NOS-CLOS 8799 OPN WOUND SITE NOS-COMPL 86803 PERITONEUM INJURY-CLOSED 9060 LT EFF OPN WND HEAD/TRNK 86804 RETROPERITONEUM INJ-CL 9081 LATE EFF INT INJ ABDOMEN 86809 INTRA-ABDOM INJ NEC-CLOS 9082 LATE EFF INT INJURY NEC 86810 INTRA-ABDOM INJ NOS-OPEN 9391 FOREIGN BODY UTERUS 86813 PERITONEUM INJURY-OPEN 9474 BURN OF VAGINA & UTERUS 86814 RETROPERITONEUM INJ-OPEN

Denominator

Discharges in the numerator are assigned to the denominator based on the Metro Area1 or county of the patient residence, not the Metro Area or county of the hospital where the discharge occurred.

1 The term ”metropolitan area“ (MA) was adopted by the U.S. Census in 1990 and referred collectively to metropolitan statistical areas (MSAs), consolidated metropolitan statistical areas (CMSAs), and primary metropolitan statistical areas (PMSAs). In addition, “area” could refer to either 1) FIPS county, 2) modified FIPS county, 3) 1999 OMB Metropolitan Statistical Area, or 4) 2003 OMB Metropolitan Statistical Area. Micropolitan Statistical Areas are not used in the QI software. Page 2